Common challenges for health systems include billing complexities, providing sufficient resources and personnel, and member engagement and compliance across various health measures. 

• The social determinants of health are essential for whole-person care, and have spurred the creation of managed care programs by all stakeholders. These programs address non-clinical risks including screening challenges, the inability to bill through standard claims processes, lack of community resources to refer patients to, and disjointed care between clinical and social service systems.  Sacramento Covered and Blue Shield’s Promise Health Plan discussed the new work they were doing in both screening and addressing Social Determinants of Health (SDoH).  
• Telehealth has been a solution proposed by numerous plans to achieve network adequacy for both mental health and primary care services. However, the ability to measure quality in telehealth poses an obstacle, but could be achieved through real-time quality measurement technology.   
• Governor Newsom’s plan for the aging population includes increased resources to meet demands for: 
  • In-Home Support Services (IHSS)
  • An Alzheimer’s Prevention and Preparedness Task Force
  • Close monitoring of quality and chronic care measure performance. 
  • Addressing heavy utilization and accountability of data. 
• As discussed by panelists, the difficulties in mental health integration remain omnipresent. Patients may never receive follow-up treatment after an event, mental health settings are continually stigmatized, and mental health and substance abuse screenings are underutilized. One bright spot is for organizations who provide all services under one roof – focusing on whole-person care, and providing a de-stigmatized environment that is effective in combating these issues.